RRS Education Chiropractic BLOG - Musculoskeletal Research Reviews

Within many chiropractic offices and existing clinical guidelines, non-specific low back pain (NS-LBP) is diagnosed when no specific structural cause can be identified. However, there is some controversy regarding the use of this term, as opponents claim that it conveys the clinician doesn’t know what is wrong with the patient and that the term is a barrier to individualized care. As a result, clinicians commonly use other labels for low back pain in order to suggest a structural source of the pain such as disc bulge, degeneration, arthritis and lumbar strain to identify issues in the intervertebral discs, facet joints, lumbar ligaments and lumbar muscles. However, problems related to these terms stem from the low validity to identify these potential structural sources of low back pain, the degree of clinical importance of these structural findings such as the degree of disc bulges in asymptomatic individuals, and the negative connotation that structural labels can carry.
It is well documented that patients want an explanation for their low back pain but concerns arise regarding the vocabulary that clinicians use. For example, some vocabulary used may result in patients desiring unnecessary lumbar imaging despite it not changing the eventual plan of management.
There is no literature on the impact of different diagnostic labels for low back pain. Therefore, the aim of this study was to investigate the effects of diagnostic labels for low back pain on patients’ perceived need for imaging. Secondary aims were to evaluate the effects of labelling on willingness to undergo surgery, beliefs about the need for a second opinion, perceived seriousness of low back pain, recovery expectations, and beliefs about the ability to engage with work and physical activities.
THIS WEEK'S RESEARCH REVIEW: “Effect of Diagnostic Labelling on Patients’ Perceived Need for Imaging for Low Back Pain”
This paper was published in the European Journal of Pain (2022) and this Review is posted in Recent Reviews, Low Back Pain, Diagnostic Imaging and the 2023 Archive.
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